Conventional practice in reduction or fixation of fractured facial bones involving the teeth and other maxillo-mandibular injuries include placing a splint or arch bar external to the teeth and secured by adhesives or wire to the teeth. An upper bar and a lower bar are connected by wire or flexible elastic bands, as shown by Richter, U.S. Pat. No. 4,230,104. The upper and lower bars have attachment points, called lugs, on the outer surface for the wire or bands. These attachment points cause trauma to the soft tissue on the inside of the mouth and lips. The trauma is a source of discomfort, pain and infection to the patient.
Another conventional way of fixing the upper and lower jaws after corrective maxillomandibular surgery or trauma is by immobilizing either the maxillary or mandibular structures by use of elongated bars which are secured to the buccal and labial faces of the patients teeth. These arch bars are secured by fine circumdental wires that are wrapped around some of the teeth. These arch bars allow for the circumdental wires to be placed only above or below the arch bar itself. The installation of these arch bars takes considerable time during which the patient is typically under a general anesthetic facing the problems therewith.
Other securements include the use of several small brackets which are secured to the patients teeth and then interconnected by a complex set of maxillo-mandibular fixation wires. The interconnecting by wires is complex and presents jagged outer surfaces that can cause discomfort to the patient.
Fields, U.S. Pat. No. 6,086,365, discloses another arch bar with studs on the exterior surface for securing ligature wires. The exposed ligature wire, as well as the studs, can cut or otherwise traumatize the inside of the mouth.
Baer, U.S. Pat. No. 5,184,995 discloses a device for temporary dental splinting employing a wire on which annular composite carriers are arranged. The composite carriers are flexible synthetic material, such as extruded tube which allows plastically deformability by finger pressure.
Gatewood, U.S. Pat. No. 4,813,869 discloses a jaw fixation device employing an anchor member mounted around one or more of the teeth on each jaw which are then strapped together.
Campbell, U.S. Patent Appl. No. 2002/0068254 Al discloses a jaw anchorage device which employs a flexible belt that extends around and between the teeth. A locking means is a plurality of inclined teeth on both a second section of the belt and an inner face of a locking head whereby the teeth cooperate such that belt can only pass through the aperture in one direction.
What is needed in the art is an arch bar with attachment points for ligature wire that presents a smooth outer surface reducing trauma to the tissue of the mouth. Also needed is an arch bar that allows for the circumdental wires to pass “through” the arch bar as well as above or below the arch bar.